Latest on Casey

As many of you have gathered from my post on the 22nd. Casey was in a relatively stable situation. From that post:

For dear, sweet Casey he is facing a very long haul. Dr. Jim, our vet neighbour and close friend, recommended that Casey start taking a steroid and he is now on Prednisone.

Indeed, Dr. Jim came by last Friday evening and said that even though there was little sign of a positive change in Casey’s condition it was still very early days.

Then on Saturday morning, when Jean went into the kitchen where Casey is with Ruby and Paloma, there had been an unexpected and sudden turn for the worse. For Casey could not adequately stand because his neck pain was too great and his front legs were giving way.

At Southern Oregon Veterinary Specialty Center, we understand the special bond between a pet and their human family. Our team of highly trained doctors, certified technicians and support staff partner with your family veterinarian to provide specialized diagnostics, surgery and emergency care for your pet upon a referral or emergency basis. Our clinic is staffed 24 hours-a-day, 7 days a week, to receive emergency cases and to monitor our critical care patients. The clinic’s board-certified veterinary specialists and staff are committed to providing exceptional compassionate care utilizing state-of-the-art technology and treatments.

The relationships we have with partner veterinarians are vital to the success of treating your pet. We will keep them apprised of the patient’s status to provide a smooth and cohesive experience.

SOVC had no doubt that we had done the right thing and that the pain meds we were giving Casey Tramadol and two muscle-relaxers, just were not strong enough. Their prognosis was that Casey be admitted to SOVC so he could be given more appropriate pain control, via an IV, and that as soon as possible he be scanned using an MRI.
Luckily, not too far away from where SOVC are located, near Medford, there is a specialist animal imaging unit: Sage Veterinary Imaging:

About SVI

Sage Veterinary Imaging was founded in 2007 to provide the highest quality diagnostic imaging services to animals in the Southern Oregon area. When I moved to the Rogue Valley, I was saddened to hear that animals needing advanced diagnostic imaging had to be driven hundreds of miles to get the care they needed. Now we provide the only ACVR board-certified veterinary imaging services right here in Southern Oregon, serving patients from Redding, to Eugene. Our administrative offices are located in Jacksonville and diagnostic services, including MRI, are provided in partnership with imaging centers in communities throughout Southern Oregon.

Even better, Dr. Jim knows Jamie Sage and speaks highly of her.

Jaime Sage, is a veterinarian who is board-certified by the American College of Veterinary Radiology. She holds a DVM from Texas A&M, an MS from The Ohio State University, and is licensed to practice in Oregon and California. Dr. Sage has issued reports for over 1,000 MRI studies in her career, and has personally performed nearly 100 onsite MRI procedures in Southern Oregon in just the past three years. Dr. Sage also works as a radiologist for MR Vets, founded by WSU Professor Emeritus Patrick R. Gavin, DVM, PhD, DACVR/RO, author of Practical Small Animal MRI, and one of the early pioneers in veterinary MRI.

Thus this morning, as in Monday morning Oregon time, SOVC will have the analysis from Jaime Sage followed by the surgical analysis by Dr. Steve Ferreira, the SOVC surgeon, who would conduct the surgery.

So more news just as soon as we have it.

Thank you all for your care and concern.

ooOOoo

UPDATE as at 12:40 PST

The surgeon, Steve Ferreira, called us to pass on the findings:

The MRI showed there to be several lesions that are not disc related,

There is an area of large compression, 50%-70% in some spots, in the lower cervical chord,

Separately, changes were noted in the C2 vertebra that suggested localised bone inflammation,

Lastly, there was an increased density pattern in the muscles associated with the cervix.

Dr. Steve said that the next step was to use a spinal tap to withdraw some spinal fluid. If it was cloudy that might indicate infection that could be treated with antibiotics. If the fluid was clear then it would be sent to an external lab for analysis. Possibilities include infection or cancer or an auto-immune issue, even possibly meningitis.

Apparently, surgery in that lower part of the spine would be very difficult to undertake. Likewise, removing a tumour that would simply regrow.

The cost of the anesthesia for the spinal tap, the insertion of the tap and the analysis would be in the order of several hundred dollars.

(Please accept that my understanding of what Dr. Steve said might not be 100% accurate. So use caution if any of this is relevant for your animal.)

ooOOoo

UPDATE as at 17:20 PST

Steve Ferreira rang following the drawing of a sample of Casey’s spinal fluid.

The fluid “didn’t look too bad”, as in it was clear,

In other words, it was not immediately indicating an infectious disease, that would cause the fluid to appear cloudy,

Dr. F. will await further results from an external laboratory later this evening,

If both the white-cell count and proteins are more-or-less normal, then,

It will suggest that the problem is not an infection,

And, therefore, most probably related to a tumour on or around C6 where the MRI recorded the excessive compression,

Casey is comfortable owing to the strong pain medication being given to him via an IV.

Jean and I will be speaking with Dr. F. in the morning but it is more likely than not that Casey is terminally ill.

This post will, therefore, be updated in the morning.

UPDATE as at 08:40 Tuesday, 28th

Dr. Steve rang us at 08:30 this morning.

He started Casey on antibiotics yesterday evening in case the lab came back with evidence of infection in the spinal fluid, but,

The lab reported that the fluid was normal in terms of blood-cell counts and protein levels, therefore,

the probability is that Casey has a tumour,

or possibly an infection inside the spinal column but outside the spinal fluid.

If such an infection, called an “empyema” then the degree of compression to the spine suggests it could be 3 to 4 weeks before Casey would be walking again.

More probable is that it is a tumour.

Casey is most definitely suffering and very miserable.

Jean and I then quickly, and very sadly, were of the opinion that Casey’s quality of life was too low for it to be fair to Casey for his life to be prolonged. We rang Dr. Steve back and asked that Casey be euthanised, cremated and that the ashes be returned to us.

In that return call, Dr. Steve quietly confirmed his support for our decision.

Casey will be very badly missed. I will be publishing an obituary tomorrow.

Our internet connection was down (once again!) until just a few minutes ago. I have just read out your precious thoughts and wishes aloud to Jeannie. We are both very moved.

In a conversation with SOVC around 7pm last night we were told that Casey was back from Sage Imaging, that he was resting comfortably and that today’s duty doctor, once Casey had been seen, would telephone us with the results from the MRI.

I am so sorry poor Casey is in a rough spot. But as you have written he’s in good hands and I’m sure the veterinarians at the specialty hospital are quite competent and will perform the best surgery possible if surgery is deemed necessary. I’m sending healing thoughts for Casey and I’m praying for a favorable outcome.

I’m glad that you were referred to a vet specialty hospital. I’m strongly in favor of using specialty hospitals. For one thing they are all board certified and the vets are all well seasoned. As a rule this type of hospital is less costly than a university veterinary hospital. Many times operations are done by vets working on internships and or residencies and some but not all are supervised by the profs. My daughter told me this and it is true. I have used Texas A&M two times and each time it was a resident who saw my cat. Not to down play the residents, I was very satisfied for the most part but my bill was quite hefty. It is easier for me to get to College Station-100 miles away and it is not an interstate highway, however, now if one of my animals needs a specialist I hire someone to drive my animal to Austin for me. I can’t hack I-35, (anxiety and tension) it is under constant construction with many trucks.

So very sorry for your loss, Paul. Casey could not have asked for more diligent care. Although the loss is great, he is without pain now across the Bridge. Loving thoughts and prayers are being sent to you and Jean. ~ ღonika, Sam, & Elsa 🐾